DiMariano Family Dentistry Blog

Posts for: September, 2019

By Drs. Jeff DiMariano & Shaina DiMariano
September 22, 2019
Category: Uncategorized
Tags: dental implant  
TheDigitalRevolutionIsTransformingImplantTherapy

Compared to other dental restorations—a few of which have been around for over a century—implants are a relatively recent development. But even though it's just now entering its fourth decade, recent advances have catapulted implant therapy well beyond where it began.

That's due mainly to digital technology. Two examples of this, computed tomography (CT) and 3-D printing, are increasing the accuracy and efficiency of implant placement.

Properly placing an implant is one of the most important elements in achieving a natural and attractive result. But finding the best location is often difficult due to a lack of suitable bone volume, the patient's bite or the proximity of anatomical structures like nerves and blood vessels. CT imaging, especially Cone Beam CT scanners (CBCT), is helping to make implant placement planning easier.

Unlike the static, two-dimensional views of standard x-rays, CBCT takes hundreds of images and digitally blends them together to create a virtual 3-D model of the patient's jaw and face. Dentists can view this highly detailed model on a computer monitor from various vantage points and better identify possible obstructions. With better information about what "lies beneath," they can more accurately pinpoint the best implant site.

Creating the ideal plan is one thing—successfully implementing it is another. Dentists often create a surgical guide that helps them drill in precisely the right positions during surgery. The guide, which resembles a mouthguard, fits over the gums and contains marker locations for drilling.

Many dentists are now using 3-D printing to create these surgical guides. A 3-D printer turns a digital model of the guide based on measurements of the patient's mouth and proposed implant locations into an actual physical object "printed out" layer by layer of special polymer material. The end product can be more precise than guides created by other means.

These and other technological developments are helping implant therapy rise to a new level of success. With the resulting increase in accuracy, efficiency and less treatment time, tomorrow's implant patients will be the ultimate beneficiaries.

If you would like more information on restoring missing teeth with dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Technology Aids Dental Implant Therapy.”


By Drs. Jeff DiMariano & Shaina DiMariano
September 12, 2019
Category: Dental Procedures
Tags: dental implant  
IfAppropriateAntibioticsbeforeImplantSurgeryCouldReduceInfectionRisk

Millions of microorganisms call your mouth home—and while most are friendly, some are not. An invasive procedure like implant surgery can disrupt the mouth's soft tissues and allow disease-causing bacteria to enter the bloodstream.

This isn't necessarily a major concern if your immune system is sound—your body will move quickly to quash any developing infection. But if your body's defense is weak or compromised by other health conditions, an ensuing infection could cause you problems. In the case of a dental implant, a localized infection around it could lead to its failure.

The bone normally grows and adheres to the surface of an implant soon after it's placed, giving it the added strength and durability for which implants are best known. A bacterial infection, though, could impede bone integration and weaken the implant's hold within the jaw.

One way to avoid this is by treating patients at high risk for infection with an antibiotic before the procedure. In one recent study, researchers concluded that patients receiving a 2-gram dose of amoxicillin an hour before implant surgery helped reduce the risk of future implant failure.

But before taking this route, the dentist must first decide whether antibiotic pre-treatment might be more detrimental than beneficial to an individual patient. Antibiotics can cause side effects in certain people ranging from diarrhea to allergic reactions. Healthcare providers must also be prudent with administering antibiotics for the good of society in general—overuse can potentially give rise to antibiotic-resistant bacteria.

A number of healthcare associations highly recommend antibiotic pre-treatment for any dental patient with prosthetic heart valves, a history of infective endocarditis, a heart transplant and similar heart conditions. They also recognize patients with conditions like prosthetic joints, weakened immune systems, diabetics or other serious health problems could also benefit from antibiotic pre-treatment, but leave it to the physician's discretion on whether or not it's appropriate for an individual patient.

If you're planning to undergo implant surgery or a similar procedure and are concerned about infection, speak with your dentist about whether you would qualify and benefit from antibiotic pre-treatment. If appropriate, taking an antibiotic beforehand could minimize your infection risk.

If you would like more information on pre-surgical antibiotic treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Implants & Antibiotics: Lowering Risk of Implant Failure.”


By Drs. Jeff DiMariano & Shaina DiMariano
September 02, 2019
Category: Oral Health
Tags: tooth decay  
YourReoccurringSinusInfectionsMayActuallyBeCausedbyToothDecay

If you suffer frequent sinus infections, you might want to talk with your dentist about it. It could be your chronic sinus problems stem from a deeply decayed or infected tooth.

Sinuses are hollow, air-filled spaces in the front of the skull associated with nasal passages. The largest, the maxillary sinuses, are located just behind the cheekbones and above and to the rear of the upper jaw on either side of the face. These sinuses can become painfully congested when infected.

One possible cause for an infection in the maxillary sinus can occur in certain people whose upper back teeth (the molars and premolars) have roots that are close to or even protrude into the sinus. This is normally a minor anatomical feature, unless such a tooth becomes infected.

An infection in teeth with advancing decay or whose nerve tissue has died will eventually reach the root tip through tiny passageways called root canals. If the roots are close to or penetrating the maxillary sinus, the infection could move into the sinus. This is known as Maxillary Sinusitis of Endodontic Origin (MSEO).

A case of MSEO could potentially go on for years with occasional flare-ups of sinus congestion or post-nasal drip. Because of the nature of the infection within the sinus, the affected tooth itself may not show the normal signs of infection like sensitivity or pain. Doctors may attempt to treat the sinus infection with antibiotics, but because the actual source of the infection is within the tooth, this therapy is often ineffective.

If your doctor or dentist suspects MSEO, they may refer you to an endodontist, a specialist in root canals and interior tooth problems. With their advanced diagnostic capabilities, endodontists may have a better chance of accurately diagnosing and locating the source of a tooth-related infection.

As with any non-vital tooth, the likely treatment will be root canal therapy in which the infected tissue within the tooth is removed and the empty spaces filled to prevent future infection. For MSEO, the treatment not only preserves the tooth but may also relieve the infection within the sinus.

If you would like more information on the possible dental causes to sinus problems, please contact us or schedule an appointment for a consultation.